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The Australasian Journal of Dermatology 1990Actinomycetomas are localised, chronic, suppurative and progressive infections of the skin, subcutaneous tissues and bones caused by aerobic actinomycetes. They are... (Review)
Review
Actinomycetomas are localised, chronic, suppurative and progressive infections of the skin, subcutaneous tissues and bones caused by aerobic actinomycetes. They are characterised by subcutaneous granulomas and abscesses with induration, formation of sinus tracts and production of granules which are the microcolonies of the causative agents.
Topics: Actinomycetales; Adult; Biopsy; Diagnosis, Differential; Humans; Male; Mycetoma; Streptomycin
PubMed: 2073207
DOI: 10.1111/j.1440-0960.1990.tb00648.x -
Transactions of the Royal Society of... Jul 2019Actinomycetoma is a syndrome of the skin characterized by chronic inflammation and lesions with nodular grain-like structures. The most common aetiological agents are...
BACKGROUND
Actinomycetoma is a syndrome of the skin characterized by chronic inflammation and lesions with nodular grain-like structures. The most common aetiological agents are Nocardia brasiliensis and Actinomadura madurae. In response to infection with these organisms the body produces an inflammatory immune response in the skin. The aim of the present study was to determine the production of chemokines, pro-inflammatory cytokines, antimicrobial peptides and the expression of Toll-like receptors (TLRs) in keratinocytes infected by A. madurae.
METHODS
A cell line of HaCaT keratinocytes was infected with A. madurae at a multiplicity of infection of 20:1 for 2 h and the samples were collected from 2 to 72 h post-infection. Intracellular replication of the bacterium was evaluated by counting of colony-forming units, the TLR expression and antimicrobial peptide production were assayed by confocal microscopy and chemokine and pro-inflammatory cytokine levels were determined by enzyme-linked immunosorbent assay.
RESULTS
Early in the infection, A. madurae was able to achieve intracellular replication in keratinocytes, however, the cells eventually controlled the infection. In response to the infection, keratinocytes overexpressed TLR2 and TLR6, produced high concentrations of cytokines monocyte chemoattractant protein-1, interleukin 8, human β-defensin-1, human β-defensin-2 and LL37 and low levels of tumour necrosis factor α.
CONCLUSIONS
The human keratinocytes contribute to the inflammatory process in response to A. madurae infection by overexpressing TLRs and producing chemokines, pro-inflammatory cytokines and antimicrobial peptides.
Topics: Actinobacteria; Actinomadura; Cytokines; Enzyme-Linked Immunosorbent Assay; Humans; Inflammation; Keratinocytes; Mycetoma; Skin Diseases, Bacterial
PubMed: 30989203
DOI: 10.1093/trstmh/trz022 -
The Journal of Dermatological Treatment Mar 2022Actinomycetoma due to is susceptible to numerous chemotherapeutic agents, however, the response to those treatments is variable and closely related to several factors.
BACKGROUND
Actinomycetoma due to is susceptible to numerous chemotherapeutic agents, however, the response to those treatments is variable and closely related to several factors.
OBJECTIVE
We aimed to evaluate the clinical-therapeutic characteristics of patients with actinomycetoma due to with two treatment modalities.
METHODS
This was a retrospective study of eighteen patients with a diagnosis of actinomycetoma. The most widely used therapeutic scheme was streptomycin 1 g every third day plus TMP/SMX 800 mg/160 mg/12h, followed by TMP/SMX with DDS 100 mg/day. In six patients (33%), ciprofloxacin 500 mg every 12 h was used instead of DDS.
RESULTS
Conventional scheme achieved clinical and mycological cure in 58% of the cases, improvement in 16%, and 25% of the patients failed to treatment; in the cases treated with ciprofloxacin, clinical and microbiological cure was achieved in 83% of patients and clinical improvement in 16%. The treatment time to achieve clinical and mycological did not have a statistically significant difference (median 10 ± 1.38 vs. 12 ± 4.6).
CONCLUSION
Treatment based on streptomycin + TMP/SMX with ciprofloxacin was found to be effective in treating patients with actinomycetoma, and comparable to the conventional treatment with DDS in actinomycetoma due to with minimal bone involvement.
Topics: Actinomadura; Humans; Mycetoma; Retrospective Studies; Trimethoprim, Sulfamethoxazole Drug Combination
PubMed: 32643472
DOI: 10.1080/09546634.2020.1793887 -
Indian Dermatology Online Journal 2021Mycetoma is a chronic, granulomatous disease caused by fungi (eumycetoma) or aerobic filamentous actinomycetes (actinomycetoma). is one of the most frequent...
CONTEXT
Mycetoma is a chronic, granulomatous disease caused by fungi (eumycetoma) or aerobic filamentous actinomycetes (actinomycetoma). is one of the most frequent actinomycetes.
AIM
The study aims to provide an update on clinical, diagnostic, therapeutic, and outcome data for patients with actinomycetoma in a single center in Mexico.
SETTINGS AND DESIGN
This was a retrospective study of 47 cases diagnosed with actinomycetoma.
SUBJECTS AND METHODS
The cases were selected from a total of 536 mycetoma obtained during 35 years (from 1985 to 2019). Clinical data were retrieved from the clinical records of our department. Microbiological data were obtained from our Mycology laboratory.
STATISTICAL ANALYSIS
Frequencies and percentages were used for categorical variables. Normality was determined with the Kolmogorov-Smirnov test. We used means and medians to describe the variables.
RESULTS
Forty-seven patients with actinomycetoma were included; female:male ratio 1.9:1; median age 38 years. The foot was the most affected region in 76.5% of cases. The bone invasion was observed in 89%. The time between symptoms onset and diagnosis was 5.5 years. Grain detection by direct examination was positive in 95% of cases. The most commonly used, as well as the most effective treatment scheme was streptomycin + sulfamethoxazole-trimethoprim with dapsone. Sixty-three percent (30 patients) achieved clinical and mycological cure, and 10.6% (5 patients) had treatment failure.
CONCLUSIONS
We highlight the importance of designing therapeutic strategies to standardize treatments and gain more experience to improve the care of these patients.
PubMed: 33959526
DOI: 10.4103/idoj.IDOJ_474_20 -
Clinical Case Reports Jul 2022The mycetoma is a granulomatous chronic disease, subcutaneous disease is the common presentation, very few cases are reported affecting central nervous system, but there...
The mycetoma is a granulomatous chronic disease, subcutaneous disease is the common presentation, very few cases are reported affecting central nervous system, but there are not cases in Renal Transplant (RT).
PubMed: 35898749
DOI: 10.1002/ccr3.6071 -
Mycopathologia Mar 1987Twenty seven cases of actionomycotic mycetoma caused either by Actinomadura madurae or Actinomadura pelletierii have been described. Infection by A. madurae has been...
Twenty seven cases of actionomycotic mycetoma caused either by Actinomadura madurae or Actinomadura pelletierii have been described. Infection by A. madurae has been more common than A. pelletierii. Left foot in A. madurae and right foot in A. pelletierii infections were involved more commonly in adult males, whereas right foot of the females was frequently affected in A. madurae infection. Large, soft, white grains in A. madurae and small, firm, red grains in A. pelletierii were consistently seen. Deep hematoxylin stained grains with scalloped margin and prominent eosinophilic club in A. madurae and such deep stained grains with smooth margin and horizontal cracks appearing as portions of a spherical mass in A. pelletierri were diagnostic. Large numbers of plasma cells and Russel bodies were also characteristic of A. madurae infection. Both the grains were stainable with Von Kossa method for calcium. Bone changes were similar in both the infections. Oral tetracycline produced soft tissue and bone resolution to almost normalcy in those who regularly consumed the drug any time from 2 to 6 years. Mild glucose intolerance, facial hyperpigmentation and urticaria were the side effects observed in a few. Two patients developed cataract following tetracycline therapy. The value of medical therapy with oral tetracycline in Actionomadura mycetomas is emphasized.
Topics: Actinomycetales; Adolescent; Adult; Aged; Female; Foot Dermatoses; Humans; Male; Middle Aged; Mycetoma; Radiography; Tetracycline
PubMed: 3574438
DOI: 10.1007/BF00437238 -
Applied Microbiology Jul 1969Thirteen red strains of Actinomadura (Nocardia) pelletieri and three of A. madurae were shown to produce prodigiosin-like pigments. Both of the two major pigments which...
Thirteen red strains of Actinomadura (Nocardia) pelletieri and three of A. madurae were shown to produce prodigiosin-like pigments. Both of the two major pigments which were observed on thin-layer chromatograms had R(F) values significantly greater than prodigiosin. The main pigment from A. madurae 953 was shown by mass and nuclear magnetic resonance spectroscopies to be nonylprodigiosin. The major pigment from A. pellitieri had a C(11)H(22) side chain in a ring form, but it was distinctly different from metacycloprodigiosin. "Prodiginine" was proposed as a name for the invariant aromatic portion of the prodigiosin structure.
Topics: Anti-Bacterial Agents; Chromatography; Chromatography, Thin Layer; Magnetic Resonance Spectroscopy; Nocardia; Pigments, Biological; Prodigiosin; Pyrroles; Spectrum Analysis
PubMed: 5803627
DOI: 10.1128/am.18.1.1-3.1969 -
The Journal of Antimicrobial... Dec 2022Actinomycetoma is a chronic granulomatous disease affecting skin, subcutaneous tissue, fascia, muscle and bones. With increasing resistance against commonly used...
OBJECTIVES
Actinomycetoma is a chronic granulomatous disease affecting skin, subcutaneous tissue, fascia, muscle and bones. With increasing resistance against commonly used treatment regimens, susceptibility testing is urgently needed.
METHODS
We developed an in vitro susceptibility assay for Actinomadura madurae, one of the common causative agents of actinomycetoma, employing resazurin for endpoint reading. Using this assay, reproducible MICs were determined for the most commonly used antibacterial agents for actinomycetoma treatment. The tested antibacterial agents included trimethoprim/sulfamethoxazole, amikacin, streptomycin, amoxicillin, ceftriaxone, gentamicin, ciprofloxacin, doxycycline, imipenem, linezolid, penicillin G and rifampicin.
RESULTS
Following the clinical breakpoints as stated by CLSI, 100% of the tested strains were susceptible to trimethoprim/sulfamethoxazole (MIC 0.03/0.59-1/19 mg/L), amikacin (MIC 0.0078-0.25 mg/L), doxycycline (MIC <0.25-1 mg/L) and linezolid (MIC <0.25-2 mg/L), 90% to ciprofloxacin (MIC <0.25-2 mg/L), 80% to ceftriaxone (MIC <0.5 to >64 mg/L) and imipenem (MIC <0.25-32 mg/L) and only 20% to amoxicillin (MIC <0.5 to >64 mg/L) and rifampicin (MIC 0.5 to >32 mg/L).
CONCLUSIONS
Determinations of MICs by visual readings of colour changes versus spectrophotometric readings were comparable. This convenient visual reading has the advantage of feasible implementation in endemic settings.
Topics: Humans; Amikacin; Linezolid; Doxycycline; Ceftriaxone; Rifampin; Mycetoma; Anti-Bacterial Agents; Amoxicillin; Trimethoprim, Sulfamethoxazole Drug Combination; Imipenem; Ciprofloxacin; Ifosfamide; Microbial Sensitivity Tests
PubMed: 36315595
DOI: 10.1093/jac/dkac367 -
Indian Journal of Pathology &... Apr 1991Two hundred and ten histologically diagnosed cases of mycetoma filed in the Departments of Pathology of four Medical Colleges in Tamil Nadu, India, between 1964-1987...
Two hundred and ten histologically diagnosed cases of mycetoma filed in the Departments of Pathology of four Medical Colleges in Tamil Nadu, India, between 1964-1987 were subjected to detailed histopathological study; Actinomadura madurae, was found in 73 of them. In nine cases of mycetoma pedis, the organism A. madurae has been isolated in pure culture. In one case, the lesions were present in both the feet. The characteristic cream-coloured granules were seen in all. The lesions responded well to a combination of Streptomycin and dapsone.
Topics: Actinomycetales; Actinomycetales Infections; Adult; Female; Humans; India; Male; Mycetoma
PubMed: 1752637
DOI: No ID Found -
Clinical and Experimental Dermatology Mar 2019Mycetoma caused by either filamentous fungi (eumycotic) or bacteria (actinomycotic) has recently been recognized by the World Health Organization as a neglected tropical... (Review)
Review
Mycetoma caused by either filamentous fungi (eumycotic) or bacteria (actinomycotic) has recently been recognized by the World Health Organization as a neglected tropical disease. Although mycetoma is preventable and treatable, especially in the early stages, it carries high morbidity and a huge socioeconomic burden. Skin and subcutaneous tissue is affected, with a classic presentation of hard woody swellings, discharging sinuses and presence of grains (containing the causative organism). Variants with swelling without sinuses have also been described. Left untreated it may involve underlying bone and muscle, leading to permanent disability. Common actinomycotic species include Streptomyces somaliensis, Actinomadura madurae, Actinomadura pelletieri, Nocardia brasiliensis and Nocardia asteroides, while Madurella mycetomatis, Madurella grisea, Pseudoallescheria boydii and Leptosphaeria senegalensis are common eumycotic agents. Men are more commonly affected than women, and the leg is the most frequently affected site. Diagnosis in suspected lesions is made with the help of grain examination, microscopy, imaging (radiography, ultrasonography, magnetic resonance imaging) and culture, and more recently by molecular methods such as PCR and molecular sequencing. Molecular sequencing for both fungi and bacteria is important for rapid and correct diagnosis, especially in culture-negative cases. Treatment is long, more successful in actinomycetoma than eumycetoma, and may require a holistic approach comprising antimicrobials, surgery and rehabilitation. Mycetoma can be prevented by simple measures such as wearing protective garments and shoes, especially in rural areas and during outdoor activities.
Topics: Actinomyces; Anti-Bacterial Agents; Antifungal Agents; Humans; Mycetoma; Skin
PubMed: 29808607
DOI: 10.1111/ced.13642